CN111920489A - Spirally-telescopic lower shell assembly for minimally invasive surgery - Google Patents
Spirally-telescopic lower shell assembly for minimally invasive surgery Download PDFInfo
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- CN111920489A CN111920489A CN202010784981.9A CN202010784981A CN111920489A CN 111920489 A CN111920489 A CN 111920489A CN 202010784981 A CN202010784981 A CN 202010784981A CN 111920489 A CN111920489 A CN 111920489A
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- cannula
- sleeve
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- lower housing
- wall
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3419—Sealing means between cannula and body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3443—Cannulas with means for adjusting the length of a cannula
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Abstract
The invention discloses a lower shell component capable of spirally extending and retracting for minimally invasive surgery, which comprises a lower shell, a first sleeve and a second sleeve, wherein the lower shell is provided with a first end and a second end; the lower shell comprises a far-end shell, one end of the transition shell is connected with the far-end shell, and the other end of the transition shell extends and is connected with the first sleeve; the first cannula including a first cannula proximal end and a first cannula distal end and a first cannula wall extending therebetween, the second cannula including a second cannula proximal end and a second cannula distal end and a second cannula wall extending therebetween; the outer surface of the second casing wall comprises external threads, and the external threads start from the adjacent area of the proximal end of the second casing and extend to the adjacent area of the distal end of the second casing; the inner surface of the first sleeve wall comprises an internal thread matched with the external thread; the proximal end of the second sleeve is mounted inside the first sleeve, and the external thread and the internal thread are matched with each other.
Description
Technical Field
The invention relates to a minimally invasive surgical instrument, in particular to a spirally telescopic lower shell assembly for minimally invasive surgery.
Background
A puncture instrument is a surgical instrument used in minimally invasive surgery (especially hard-tube endoscopic surgery) for establishing an artificial passage into a body cavity. Typically consisting of a cannula assembly and a needle. The general clinical use mode is as follows: a small opening is cut on the skin of a patient, the puncture needle penetrates through the cannula assembly, and then the puncture needle penetrates through the abdominal wall through the skin opening to enter a body cavity. Once inside the body cavity, the needle is removed, leaving the cannula assembly as a passage for the instrument into and out of the body cavity.
In the hard tube laparoscopic surgery, a pneumoperitoneum machine is usually adopted to continuously perfuse gas (such as carbon dioxide gas) into the abdominal cavity of a patient and maintain a stable gas pressure (about 13-15 mmHg) so as to obtain a sufficient operation space. Cannula assemblies are typically comprised of a cannula, a housing, a sealing membrane (also known as an instrument seal) and a zero seal (also known as a self-seal). The cannula assembly penetrates from outside the body cavity to inside the body cavity to serve as a passage for instruments to and from the body cavity. The housing connects the sleeve, zero seal and sealing membrane into a sealed system. The zero seal generally does not provide a seal for the inserted instrument, but automatically closes and forms a seal when the instrument is removed. The sealing membrane grips the instrument and forms a seal as the instrument is inserted.
When the cannula assembly is secured to the abdominal wall of a patient, the cannula may be divided into an external body segment (length H1), a body wall segment (length H2) and an internal body segment (length H3). The length H2 of the body wall segment varies, and when applied to different patients, the abdominal wall thickness varies from patient to patient, e.g., obese patients and the smaller abdominal wall thickness varies more greatly; the wall section H2 varies for different puncture positions and puncture angles even when used with the same patient. The length H1 of the external section of the body cannot be reserved too long or too short, which is inconvenient for inserting the instruments, especially when the cannula assembly is used as a main operation hole and needs to be repeatedly switched, the length H1 of the external section of the body is too short, which is inconvenient for operating the instruments at different inclination angles. The length H3 of the in-vivo section is not changed greatly generally, and is reserved for 20-30 mm. The length of the sleeve assembly in the prior art is fixed, and the requirements of different scene in the field cannot be met.
Disclosure of Invention
In one aspect of the present invention, a lower housing assembly that is helically retractable for minimally invasive surgery is presented, comprising a lower housing, a first cannula and a second cannula. The lower housing includes a distal shell with one end of the transition shell connected to the distal shell and the other end extending and connected to the first cannula. The first cannula includes a first cannula proximal end and a first cannula distal end with a first cannula wall extending therebetween, and the second cannula includes a second cannula proximal end and a second cannula distal end with a second cannula wall extending therebetween. The outer surface of the second sleeve wall comprises external threads, and the external threads start from the adjacent area of the proximal end of the second sleeve and extend to the adjacent area of the distal end of the second sleeve; the inner surface of the first sleeve wall comprises an internal thread matched with the external thread. The proximal end of the second sleeve is mounted inside the first sleeve, and the external thread and the internal thread are matched with each other. Relative rotation of the first and second sleeves causes the second sleeve to rotate and move within the first sleeve.
In one scheme, the internal thread is arranged on the inner surface of the wall of the first sleeve in the vicinity of the distal end of the first sleeve, and the large diameter Dn of the internal thread; the first casing wall further comprises a cylindrical inner pipe with the diameter Dt1, wherein Dt1 is more than or equal to Dn.
In yet another aspect, the cannula assembly further comprises a cannula seal mounted to the proximal end of the second cannula, the cannula seal comprising a cylindrical sealing wall having a diameter Dt2, wherein Dt2 > Dt 1.
In yet another aspect, a cannula assembly includes a lower housing assembly that is helically retractable, and further includes an upper housing, an instrument seal and a zero seal sandwiched between the upper housing and the lower housing and in a compressed state, the upper housing and the lower housing assembly being interconnected to form an integrated sealing system. The total sleeve length Ltx of the sleeve assembly satisfies the following relationship:
Lt0≤Ltx≤(Lt0+L1-N*P-L3)
l1 — length of first sleeve,
n is the number of turns of the internal thread,
l3 — shortest distance of external thread from proximal end of second sleeve,
lt 0-initial position shortest length of total cannula length of cannula assembly,
p-the pitch of the thread.
In another scheme, the number of turns of the internal thread is N, wherein N is more than or equal to 3 and less than or equal to 5.
In yet another aspect, the length L1 of the first cannula and the initial position shortest length Lt0 of the total length of the cannula assembly satisfy the relationship: 3/Lt 0/8 is not less than L1 is not less than Lt 0/3.
In one aspect of the invention, a lower housing assembly is provided that includes a helical groove, including a lower housing, a first sleeve, and a second sleeve. The lower housing includes a distal shell with one end of the transition shell connected to the distal shell and the other end extending and connected to the first cannula. The second cannula includes a second cannula proximal end and a second cannula distal end and a second cannula wall extending therebetween, an outer surface of the second cannula wall including a helical groove extending from an area adjacent the second cannula proximal end to an area adjacent the second cannula distal end. The first cannula comprises a first cannula proximal end and a first cannula distal end with a first cannula wall extending therebetween; and the inner surface of the first sleeve wall at the far end of the first sleeve comprises M (M is more than or equal to 1) turns of spiral protrusions matched with the spiral grooves in shape and size. The proximal end of the second sleeve is arranged inside the first sleeve, and the spiral protrusion and the spiral groove are matched with each other.
In one embodiment, the helical groove and the helical protrusion are matched with each other, and the first sleeve and the second sleeve can be rotated relative to each other and axially moved by rotating the second sleeve and the first sleeve relative to each other.
In yet another aspect, the second cannula proximal end comprises a proximal cylindrical tube having a diameter Dt2, the exterior of which comprises an annular groove having a diameter Dt 5; the lower housing component further comprising a sleeve seal comprising an outer sealing cylindrical surface having a diameter Dt3 and an inner sealing cylindrical surface having a diameter Dt4, wherein Dt2 > Dt5 > Dt 4; the sleeve seal is defined in the annular groove.
In another embodiment, the first casing wall further comprises a cylindrical inner tube with a diameter Dt1, wherein the proximal end of the cylindrical inner tube extends through the proximal end of the first casing and the distal end of the cylindrical inner tube intersects the spiral protrusion; the outer sealing cylindrical surface is in contact with the inner surface of the cylindrical inner tube, wherein Dt3 is greater than Dt 1.
In another scheme, the sleeve seal is made of a thermosetting elastomer or a thermoplastic elastomer material, and the external sealing cylindrical surface of the sleeve seal and the cylindrical inner pipe are in interference fit and press to form a rotating peak force F1; a rotary external force F2 is exerted on the first sleeve and the second sleeve, and when F2 is less than or equal to F1, the first sleeve and the second sleeve do not generate relative displacement; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement. In another scheme, 10N is less than or equal to F1 is less than or equal to 20N.
In yet another aspect, a cannula assembly includes a lower housing assembly including a helical groove, and further includes an upper housing, an instrument seal and a zero seal sandwiched between the upper housing and a lower housing and in a compressed state, the upper housing and the lower housing assembly being interconnected to form an integral seal system.
In one aspect of the present invention, a lower housing assembly including a spiral protrusion is provided. Comprises a lower housing, a first sleeve and a second sleeve. The lower housing includes a distal shell with one end of the transition shell connected to the distal shell and the other end extending and connected to the first cannula. The second cannula includes a second cannula proximal end and a second cannula distal end and a second cannula wall extending therebetween, an outer surface of the second cannula wall including a helical groove extending from an area adjacent the second cannula proximal end to an area adjacent the second cannula distal end. The first cannula comprises a first cannula proximal end and a first cannula distal end with a first cannula wall extending therebetween; and the inner surface of the first sleeve wall at the far end of the first sleeve pipe comprises a spiral protrusion matched with the spiral groove in shape and size. The proximal end of the second sleeve is mounted inside the first sleeve, and the spiral protrusion and the spiral groove are matched with each other.
In one embodiment, the helical groove and the helical protrusion are matched with each other, and the first sleeve and the second sleeve can be rotated relative to each other and axially moved by rotating the second sleeve and the first sleeve relative to each other.
In another scheme, X sections are spirally raised, wherein X is more than or equal to 2; the X-section spiral protrusions are arranged on the inner surface of the first sleeve wall at the far end of the first sleeve, are distributed on the virtual spiral line matched with the spiral grooves at intervals from the far end to the near end in sequence, and are not overlapped from the far end to the near end in the projection view angle. In one scheme, X is more than or equal to 3 and less than or equal to 5.
In yet another alternative, the lower housing and the first sleeve are integrally connected and injection molded from a single mold to form a single part.
In yet another aspect, the lower housing component further comprises a sleeve seal mounted at a proximal end of the second sleeve, the sleeve seal comprising a cylindrical seal wall having a diameter Dt2, the first sleeve wall further comprising a cylindrical inner tube having a diameter Dt1, an exterior of the cylindrical seal wall being in contact with an interior surface of the cylindrical inner tube, wherein Dt2 > Dt 1.
In yet another aspect, the lower housing assembly further comprises the sleeve seal being made of a thermoset elastomer or a thermoplastic elastomer material, the extrusion force of the interference fit between the outer surface of the cylindrical seal wall of the sleeve seal and the cylindrical inner tube forming a rotational peak force F1; a rotary external force F2 is exerted on the first sleeve and the second sleeve, and when F2 is less than or equal to F1, the first sleeve and the second sleeve do not generate relative displacement; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement.
In yet another aspect, a cannula assembly includes a lower housing assembly including a helical projection, and further includes an upper housing, an instrument seal and a zero seal sandwiched between the upper housing and a lower housing and in a compressed state, the upper housing and the lower housing assembly being interconnected to form an integral seal system.
In one aspect of the invention, a lower housing assembly including a spiral protrusion is provided that includes a lower housing, a first sleeve, and a second sleeve. The lower housing includes a distal shell with one end of the transition shell connected to the distal shell and the other end extending and connected to the first cannula. The second sleeve includes a second sleeve proximal end and a second sleeve distal end and a second sleeve wall extending therebetween, an outer surface of the second sleeve wall including a helical protrusion extending from an area adjacent the second sleeve proximal end to an area adjacent the second sleeve distal end. The first cannula comprises a first cannula proximal end and a first cannula distal end with a first cannula wall extending therebetween; a helical groove of a shape and size matching the helical protrusion is included on the inner surface of the first casing wall at the distal end of the first casing. The proximal end of the second sleeve is mounted inside the first sleeve, and the helical protrusion and the helical groove are matched with each other.
In one embodiment, the helical groove and the helical protrusion are matched with each other, and the first sleeve and the second sleeve can be rotated relative to each other and axially moved by rotating the second sleeve and the first sleeve relative to each other.
In yet another aspect, the lower housing assembly further includes a sleeve seal mounted to the proximal end of the second sleeve.
In yet another aspect, the boot seal includes a sealing cylinder defining an outer sealing cylinder surface having a diameter Dt3 and an inner sealing cylinder surface having a diameter Dt 4; the proximal end of the second sleeve comprises a proximal cylindrical tube with the diameter Dt2, and the inner sealing cylindrical surface and the proximal cylindrical tube are fixed by glue; the outer sealing cylindrical surface is contacted with the inner surface of the cylindrical inner tube.
In another scheme, an outer sealing cylindrical surface of the pipe sealing element is in interference fit with the cylindrical inner pipe; sufficient extrusion force is formed between the outer sealing cylindrical surface and the near-end cylindrical tube to form a rotation peak force F1, a rotation external force F2 is applied to the first sleeve and the second sleeve, and when F2 is not more than F1, the first sleeve and the second sleeve do not generate relative displacement; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement. In a specific scheme, F1 is more than or equal to 10N and less than or equal to 20N.
In yet another aspect, a cannula assembly, a lower housing assembly, an upper housing, an instrument seal and a zero seal sandwiched between the upper housing and the lower housing and in a compressed state, the upper housing and the lower housing assembly being interconnected to form an integrated sealing system.
In one aspect of the invention, a trocar assembly is provided that includes a cannula assembly and a puncture needle extending through the cannula assembly.
Drawings
For a fuller understanding of the nature of the present invention, reference should be made to the following detailed description taken together with the accompanying figures in which:
FIG. 1 is an exploded view of a tube assembly 1;
FIG. 2 is a side projection view of the cannula assembly 1;
FIG. 3 is a cross-sectional view 2-2 of tube assembly 1;
FIG. 4 is a simulated view of the cannula assembly 1 secured to the abdominal wall;
FIG. 5 is a perspective view of the lower housing assembly 40 a;
fig. 6 is a perspective view of the lower housing 100;
FIG. 7 is a cross-sectional view of the lower housing assembly 40 a;
FIG. 8 is an enlarged view of a portion 8-8 of FIG. 7;
FIG. 9 is a schematic perspective view of the first sleeve assembly 200 a;
FIG. 10 is a cross-sectional view of the lower housing assembly 40 b;
FIG. 11 is an enlarged view of a portion 11-11 of FIG. 10;
FIG. 12 is an enlarged view of a portion 12-12 of FIG. 10;
FIG. 13 is a cross-sectional view of the lower housing assembly 40 c;
FIG. 14 is an enlarged partial view of 14-14 of FIG. 13;
FIG. 15 is an enlarged view of a portion 15-15 of FIG. 13;
FIG. 16 is a schematic perspective view of the first sleeve assembly 200 c;
FIG. 17 is a distal to proximal projection view of the first cannula assembly 200 c;
FIG. 18 is a cross-sectional view of the lower housing assembly 40 d;
FIG. 19 is an enlarged fragmentary view of 19-19 of FIG. 18;
FIG. 20 is a perspective view of the lower housing assembly 40 e;
figure 21 is a perspective view of the first sleeve 200f,
figure 22 is a side projection view of the second sleeve 300f,
figure 23 is a cross-sectional view of the lower housing assembly 40f,
fig. 24 is an enlarged view of a portion 24-24 of fig. 23.
The same reference numbers will be used throughout the drawings to refer to identical or similar parts or elements.
Detailed Description
Embodiments of the present invention are disclosed herein, however, it is to be understood that the disclosed embodiments are merely exemplary of the invention, which can be embodied in various forms. Therefore, the disclosure herein is not to be interpreted as limiting, but merely as a basis for the claims and as a basis for teaching one skilled in the art how to employ the present invention. Embodiments of the present disclosure will now be described in detail with reference to the drawings, where for convenience, the party that is subsequently proximal to the operator is defined as the proximal end, and the party that is distal from the operator is defined as the distal end.
Fig. 1-3 depict a cannula assembly 1 for laparoscopic surgery. The cannula assembly 1 includes an axis 2 and, arranged axially in series, an upper housing 30, an instrument seal 10, a zero seal 20 and a lower housing 40. Wherein the instrument seal 10 and the zero seal 20 are made of a super elastic material such as silicone rubber, etc. The upper and lower housings 30, 40 are made of a rigid thermoplastic plastic such as polycarbonate. The instrument seal 10 includes a sealing lip 11 defined by a sealing membrane 17 and a sealing membrane outer flange 19. The zero seal 20 comprises a zero seal flange 29 and a zero seal body 27 connected thereto and extending distally, a pair of seal sheets 21 connected to the zero seal body 27 and extending distally to form a "duck bill" shaped openable and closable duck bill valve. The upper housing 30 includes an open cannula assembly inlet 31 defined by a proximal housing 37 and an upper retaining ring 33 coupled to the upper housing 30 and extending distally. The lower housing 40 comprises a distal housing 47, a lower retaining ring 43 coupled to the distal housing 47 and extending proximally, and a transition housing 45 coupled to the distal housing 47 and extending distally to form a cannula 50, the cannula 50 comprising a cannula passage 53 defined by a cannula wall 51, the cannula wall 51 extending distally and forming a cannula lip 55, the cannula lip 55 defining an open cannula outlet 57. In this example, the instrument seal 10 and zero seal 20 are mounted between an upper housing 30 and a lower housing 40. Wherein the zero seal flange 29, the sealant membrane outer flange 19 are sandwiched between the lower retainer ring 43 and the upper retainer ring 33 in a compressed state, the upper housing 30 further comprises an attachment post 39 connected to the proximal housing 37 and extending distally, the lower housing 40 further comprises an attachment hole 49 matching the shape and location of the attachment post, the attachment post 39 and the attachment hole 49 are in an interference fit, thereby connecting the upper housing 30, the instrument seal 10, the zero seal 20 and the lower housing 40 as an integral sealing system. In this example, the upper housing and the lower housing are connected to form a whole through the fixing column and the fixing hole in an interference manner, but various manners such as threaded connection, rotary buckle connection, glue bonding and the like can be adopted.
Referring to fig. 3 and 4, when cannula assembly 1 is inserted into a body cavity from outside the body cavity, a pneumoperitoneum machine is usually used to continuously infuse gas (e.g., carbon dioxide gas) into the body cavity of a patient and maintain a constant gas pressure (about 13-15 mmHg) to obtain a sufficient surgical operation space for instruments to pass into and out of the body cavity. When no external instrument is inserted, the pair of sealing sheets 21 of the zero seal 20 is closed, and the zero seal 20 forms a zero seal assembly with the lower fixing ring 43, the transition housing 45 and the sleeve 50, so that gas in the body cavity is prevented from leaking out of the body through the sleeve assembly. When the external instrument is inserted, the external instrument opens the zero seal, gas in the body cavity can flow to the area between the zero seal and the sealing membrane via the zero seal, but the sealing lip 11 grips the instrument and prevents gas from leaking via the sealing membrane. In this example, the sealing membrane and the zero seal are in direct contact and form a non-removable sealing system, however, the sealing membrane and the zero seal may not be in direct contact, and two separate and quick-release instrument seal assemblies and zero seal assemblies may be formed. For example, CN201610630336.5 entitled "a crimp-type piercer sealing system" discloses a structure comprising an instrument sealing assembly (first sealing assembly) and a zero sealing assembly (second sealing assembly). It will be appreciated by those skilled in the art that there are numerous implementations of the instrument seal and zero seal disclosed in the prior art, such as the four-lobed instrument seal assembly disclosed in US8029475, such as the pleated instrument seal assembly disclosed in US7789861, such as the instrument seal assembly comprising a woven cloth disclosed in US6482181, such as the four-lobed zero seal disclosed in US5443452, such as the duckbill zero seal disclosed in US8034032, and the like. Other disclosed instrument seals, zero seals and slight adaptations of their housings may be used in place of the instrument seals, zero seals, upper housing, lower housing, etc. described herein.
Referring now to fig. 4, when cannula assembly 1 is secured to the abdominal wall of a patient, cannula 50 may be divided into an extracorporeal section (length H1), a body wall section (length H2) and an intracorporeal section (length H3). The length H2 of the body wall segment varies, and when applied to different patients, the abdominal wall thickness varies from patient to patient, e.g., the difference between obese patients and the smaller abdominal wall thickness is greater; the wall section H2 varies for different puncture positions and puncture angles even when used with the same patient. The length H1 of the external section of the body cannot be reserved too long or too short, which is inconvenient for inserting the instruments, especially when the cannula assembly is used as a main operation hole and needs to be repeatedly switched, the length H1 of the external section of the body is too short, which is inconvenient for operating the instruments at different inclination angles. The length H3 of the in-vivo section is not changed greatly generally, and is reserved for 20-30 mm. The length of the sleeve 50 of the sleeve assembly 1 is fixed, which cannot meet the requirements of different scenes.
5-8 depict an improved lower housing assembly 40a including a lower housing 100, a first sleeve 200, and a second sleeve 300. The lower housing 100 comprises a distal housing 47, and a lower retainer ring 43 connected to the distal housing 47 and extending proximally; transition housing 45 is connected at one end to the distal housing and at its other end extends to form a cannula mount wall 46, said cannula mount wall 46 extending proximally and being connected to cannula stop wall 44, said cannula stop wall 44 defining lower housing throughbore 41. The first cannula 200 includes a first cannula proximal end 210 and a first cannula distal end 230 and a first cannula wall 220 extending therebetween, an inner surface of the first cannula wall 220 including internal threads 240. The second cannula 300 includes a second cannula proximal end 310 and a second cannula distal end 330 and a second cannula wall 320 extending therebetween. The inner surface of the second sleeve wall defines a hollow tube. The outer surface of the second cannula wall 320 includes external threads 340, the external threads 340 extending from a region adjacent the proximal end of the second cannula to a region adjacent the distal end of the second cannula. The second cannula distal end 330 defines a cannula lip 331.
With continued reference to fig. 7-8, the first cannula proximal end 210 is coupled to the lower housing 100. in this example, the outer surface of the first cannula proximal end 210 matches the shape and size of the cannula retaining wall 44. in one embodiment, glue is used to bond the first cannula proximal end 210 and the cannula retaining wall 44 together. Alternatively, the exterior of the proximal end 210 of the first cannula is secured as a unit by interference with the interior wall of the cannula retaining wall 44. The second sleeve proximal end 310 is mounted inside the first sleeve 200, and the external threads 340 and the internal threads 240 are mated with each other.
The first sleeve 200 has a length of L1, the total axial length Ls1 of the internal thread 240 is equal to L1, the second sleeve 300 has a length of L2, and the total axial length Ls2 of the external thread 340 is equal to the pitch P of the thread. An initial casing shortest length Lt0 of the casing of the lower casing assembly 40a, an extended casing length Ltx of the lower casing assembly 40a, wherein Ltx satisfies the relationship:
lt0 is not less than Ltx (L1+ Lt0-3 XP), and Ls2 is more than Ls 1.
It will be appreciated by those skilled in the art that when lower housing assembly 40a is substituted for lower housing 40 in cannula assembly 1 to form a new cannula assembly 1a (not shown) for laparoscopic surgery, the surgeon may rotate the first cannula to move the second cannula relative to the first cannula to vary the total cannula length Ltx depending on the thickness of the patient's abdominal wall, the position and angle of penetration of the cannula assembly, and the individual handling habits. The depth of the cannula assembly is adjusted to the desired depth in the abdominal wall, so that the cannula assembly is positioned with the desired external portion (length H1), wall portion (length H2) and internal portion (length H3).
9-12 depict an improved lower housing assembly 40b that includes a lower housing 100, a first bushing 200a, and a second bushing 300 a. The first sleeve 200a includes a first sleeve proximal end 210a and a first sleeve distal end 230a and a first sleeve wall 220a extending therebetween, and an internal thread 240a disposed on an inner surface of the first sleeve wall in a vicinity of the first sleeve distal end 230a, wherein the internal thread has a major diameter Dn, a minor diameter Dn1, a pitch P, and a number N of internal threads. The first sleeve wall 220a also includes a cylindrical inner tube 250a having a diameter Dt1, where Dt1 > Dn. The cylindrical inner tube 250a has a proximal end extending through the first sleeve proximal end 210a and a distal end intersecting the internal threads 240 a. The second cannula 300a includes a second cannula proximal end 310a and a second cannula distal end 330 and a second cannula wall 320 extending therebetween. The outer surface of the second casing wall 320 comprises an external thread 340, the external thread 340 extends from the adjacent region of the second casing proximal end to the adjacent region of the second casing distal end, the external thread has a major diameter Dw, a minor diameter Dw1 and a thread pitch P. The second cannula proximal end 310a comprises a proximal cylindrical tube 350a having a diameter Dt2, wherein Dt2 < Dw 1. The first sleeve proximal end 210a is connected to the lower housing 100, and the second sleeve 300a is installed inside the first sleeve 200a, wherein the external thread 340 and the internal thread 240a are matched with each other.
The lower housing assembly 40b further includes a sleeve seal 400 mounted at the proximal end of the second sleeve, the sleeve seal 400 including an outer sealing cylindrical surface 420 having a diameter Dt3 defined by a sealing cylinder 410 and an inner sealing cylindrical surface 430 having a diameter Dt 4. In one approach, the sleeve seal 400 is fixed to the outside of the proximal cylindrical tube 350a by glue bonding (see fig. 10 and 11). In yet another version, the exterior of the proximal cylindrical tube 350a includes a groove having a diameter Dt5, where Dt2 > Dt5 > Dt4, thereby defining the sleeve seal 400 within the groove of the exterior of the proximal cylindrical tube 350 a. In one embodiment, the cannula seal 400 is injection molded directly onto the second cannula proximal end 310a using a two shot injection molding process. In summary, there are a number of ways in which the sleeve seal 400 may be coupled to the second sleeve proximal end 310a, and other coupling arrangements are contemplated based on the teachings of the three aforementioned aspects.
The cannula seal 400 is made of a thermoset elastomer (e.g., silicone, rubber, etc.) or a thermoplastic elastomer (e.g., TPU polyurethane thermoplastic elastomer, TPEE polyester thermoplastic elastomer, styrene elastomer, etc.), wherein Dt3 > Dt1, i.e., an interference fit between the outer cylindrical surface 420 of the cannula seal 400 and the cylindrical inner tube 250a (the cannula seal 400 depicted in fig. 10-11 in a relaxed state). Sufficient squeezing force is formed between the outer sealing cylindrical surface 420 and the proximal cylindrical pipe 350a to form a rotating peak force F1, the rotating outer force F2 applied to the first sleeve and the second sleeve does not generate relative displacement when F2 is less than or equal to F1; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement. Reasonable interference is selected through an experimental method, and the material and the hardness of the sleeve sealing element 400 are reasonably selected, so that the rotating peak force F1 is controlled within a comfortable and safe range, wherein in a specific scheme, F1 is more than or equal to 10N and less than or equal to 20N. When F1 is less than 10N, the safety factor for preventing the first sleeve and the second sleeve from generating unexpected relative displacement is not high enough; when F1 is greater than 20N, the relative displacement of the first sleeve and the second sleeve caused by the rotation is not comfortable enough.
The length of the first sleeve 200a is L1, the number of turns of the internal thread 240a is N, the length of the second sleeve 300a is L2, the total length of the external thread 340 along the axial direction is Ls2, the thread pitch of the thread, and the shortest distance between the external thread 340 and the proximal end 310a of the second sleeve is L3. The lower housing assembly 40b has a sleeve initial position shortest length Lt 0. In one embodiment, N is greater than or equal to 3 and less than or equal to 5, and the extended length Ltx of the sleeve of the lower housing assembly 40a, wherein Ltx satisfies the relationship:
Lt0≤Ltx≤(Lt0+L1-N*P-L3)。
similarly, when the lower housing assembly 40b is substituted for the lower housing 40 of the cannula assembly 1 to form a new cannula assembly 1b (not shown) for laparoscopic surgery, the surgeon may rotate the first cannula to move the second cannula relative to the first cannula to change the overall length Ltx of the cannula based on the thickness of the patient's abdominal wall, the position and angle of penetration of the cannula assembly, and personal handling habits. The depth of the cannula assembly into the abdominal wall is adjusted to achieve the desired placement of the cannula assembly outer section (length H1), body wall section (length H2) and body inner section (length H3). When N < 3, the fit length of the first and second sleeves is not tight enough and smooth, and when N > 5, the fit length is too long, thereby reducing the total length (displacement) of the first and second sleeves in axial extension and contraction.
The length of first sleeve 200a is set to have a greater impact on the ease of use of sleeve assembly 1b in the field. In a preferred embodiment, the length of the first casing 200a is L1, and the casing initial position shortest length Lt0 of the lower housing component 40b is 3 × Lt0/8 ≦ L1 ≦ Lt 0/3. When L1 is greater than 3/8 of Lt0, the sleeve assembly 1b in the shortest state is inconvenient to use, and the lengths of the body wall segment (length H2) and the body inner segment (length H3) are insufficient. When L1 is less than 1/3 of Lt0, L1 is too short and the adjustable length of extension of cannula assembly 1b is not significant enough.
In another embodiment, the major diameter Dw and the minor diameter Dw1 of the external thread 340 satisfy the relationship: not less than 0.3mm (Dw-Dw 1)/not more than 2 mm. When (Dw-Dw1)/2 is less than 0.3mm, the requirements on thread manufacturing precision and matching precision are high, the friction force of the external thread wrapped on the abdominal wall wound of the patient is insufficient, and when (Dw-Dw1)/2 is greater than 0.5mm, in order to ensure sufficient strength, the outer diameter of the sleeve needs to be increased, so that the damage of the puncture wound is increased, and when the external thread is wrapped on the abdominal wall wound of the patient, the thread with the height of more than 0.5 easily causes additional damage to the wound.
7-12, the internal and external threads are isosceles triangular threads. In a further embodiment, the internal thread and the external thread are serrated threads, i.e. the thread form of the internal thread and the external thread is serrated. In an optimized design, the tooth shape of the external thread is a sawtooth shape which is inclined from the far end to the near end and gradually widens. This arrangement facilitates reducing abdominal wall penetration forces during use of the cannula assembly to penetrate the abdominal wall to establish the puncture channel, while also facilitating increasing the resistance to withdrawal of the cannula assembly from the abdominal wall. Similarly, the major diameter Dw and the minor diameter Dw1 of the external thread satisfy the relation: not less than 0.3mm (Dw-Dw 1)/not more than 2 mm.
Fig. 13-15 depict yet another modified lower housing assembly 40c, including a lower housing 100, a first bushing 200b, and a second bushing 300 b. The second cannula 300b includes a second cannula proximal end 310b and a second cannula distal end 330b with a second cannula wall 320b extending therebetween. The outer surface of the second cannula wall 320b includes M (M ≧ 1) helical projections 340f, and the helical projections 340f extend from the vicinity of the proximal end of the second cannula to the vicinity of the distal end of the second cannula. The first cannula 200b includes a first cannula proximal end 210b and a first cannula distal end 230b with a first cannula wall 220b extending therebetween. On the inner surface of the first cannula wall at the first cannula distal end 230b, a helical groove 240f is included that is shaped and sized to mate with the helical protrusion 340 f. The first sleeve wall 220b also includes a cylindrical inner tube 250b having a diameter Dt 1. The proximal end of the cylindrical inner tube 250b extends through the first sleeve proximal end 210b and its distal end intersects the helical groove 240 f. The proximal end 210b of the first sleeve is connected to the lower housing 100 and the second sleeve 300b is mounted inside the first sleeve 200b, wherein the helical protrusion 340f and the helical groove 240f are mated with each other, and the first sleeve and the second sleeve are axially movable by rotating the second sleeve 300b and the first sleeve 200b relative to each other.
With continued reference to fig. 13-15, the lower housing assembly 40c further includes a sleeve seal 400 mounted at the proximal end of the second sleeve, the sleeve seal 400 including an outer sealing cylindrical surface 420 having a diameter Dt3 defined by a sealing cylinder 410 and an inner sealing cylindrical surface 430 having a diameter Dt 4. In one version, the second cannula proximal end 310b comprises a proximal cylindrical tube 350b having a diameter Dt2, the exterior of the proximal cylindrical tube 350b comprising an annular groove 360b having a diameter Dt5, wherein Dt2 > Dt5 > Dt4, thereby defining the cannula seal 400 in the annular groove 360b in the exterior of the proximal cylindrical tube 350b, the outer sealing cylindrical surface 420 being in contact with the inner surface of the cylindrical inner tube 250 b. In one approach, Dt3 > Dt1, i.e., an interference fit between the outer cylindrical sealing surface 420 of the sleeve seal 400 and the cylindrical inner tube 250b (the sleeve seal 400 depicted in fig. 13-14 in a compressed state). Sufficient extrusion force is formed between the outer sealing cylindrical surface 420 and the proximal cylindrical pipe 350b to form a rotating peak force F1, the rotating outer force F2 applied to the first sleeve and the second sleeve does not generate relative displacement when F2 is less than or equal to F1; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement. Reasonable interference is selected through an experimental method, and the material and the hardness of the sleeve sealing element 400 are reasonably selected, so that the rotating peak force F1 is controlled within a comfortable and safe range, wherein in a specific scheme, F1 is more than or equal to 10N and less than or equal to 20N. When F1 is less than 10N, the safety factor for preventing the first sleeve and the second sleeve from generating unexpected relative displacement is not high enough; when F1 > 20N, the operating comfort of the rotation to produce the relative displacement of the first sleeve and the second sleeve is not good enough.
Similarly, when the lower housing assembly 40c is substituted for the lower housing 40 of the cannula assembly 1 to form a new cannula assembly 1c (not shown) for laparoscopic surgery, the surgeon may rotate the first cannula to move the second cannula relative to the first cannula to change the overall length Ltx of the cannula based on the thickness of the patient's abdominal wall, the position and angle of penetration of the cannula assembly, and the personal handling habits. The depth of the cannula assembly into the abdominal wall is adjusted to achieve the desired placement of the cannula assembly outer section (length H1), body wall section (length H2) and body inner section (length H3). The spiral protrusion 340f of the second sleeve 200b is opposite to the external thread 340 of the second sleeve 200, and the spiral groove 340 is more beneficial to injection molding of a thin-walled tube. Although the cross-section of the spiral groove is illustrated as a semi-circle, it may be trapezoidal or rectangular.
Fig. 16-19 depict yet another modified lower housing assembly 40d comprising a lower housing 100, a first sleeve 200c, a second sleeve 300b, and a sleeve seal 400. The casing section 40d differs from the lower casing section 40c only by the first bushing. That is, the lower housing assembly 40d is constructed with the first casing 200c instead of the first casing 200 b. The first cannula 200c includes a first cannula proximal end 210b and a first cannula distal end 230c with a first cannula wall 220b extending therebetween. A plurality of helical lobes 240c of a shape and size matching the helical lobes 340f are included on the inner surface of the first cannula wall at the first cannula distal end 230 c. The first sleeve wall 220b also includes a cylindrical inner tube 250b having a diameter Dt 1. The cylindrical inner tube 250b extends proximally through the first sleeve proximal end 210b and its distal end intersects the helical protrusion 240 c. In a specific design, the spiral protrusion 240c includes a first spiral protrusion 241c, a second spiral protrusion 242c and a third spiral protrusion 243 c. The first, second and third sections of spiral protrusions are arranged on the inner surface of the wall of the first sleeve at the far end 230c of the first sleeve, are sequentially distributed on a virtual spiral line matched with the spiral protrusions 340f at intervals from the far end to the near end, and are not overlapped from the far end to the near end in a projection view angle. As shown in fig. 19-20, similarly, the first sleeve proximal end 210b is coupled to the lower housing 100 and the second sleeve 300b is mounted within the first sleeve 200c, wherein the helical protrusion 340f and the helical protrusion 240c mate with each other and the first sleeve 200c and the second sleeve are axially movable by relative rotation of the second sleeve 300b and the first sleeve.
Compared with the first sleeve 200b, the manufacturing die and the manufacturing process of the first sleeve 200c are simplified, the manufacturing efficiency and the manufacturing precision are improved, and the production cost is greatly reduced. In addition to the 3 helical lobes shown, the helical lobes 240c are designed as X helical lobes (X ≧ 2). The X-section spiral protrusions are arranged on the inner surface of the wall of the first sleeve at the far end 230c of the first sleeve, are distributed on the virtual spiral line matched with the spiral protrusions 340f at intervals from the far end to the near end in sequence, and are not overlapped from the far end to the near end in the projection view angle, and X is more than or equal to 3 and less than or equal to 5. When the spiral protrusions with the length being more than or equal to 3 sections are adopted, the matching length is enough in the axial direction of the sleeve passing through the lower shell assembly 40d, and the first sleeve and the second sleeve are ensured to be precisely matched and move stably. The spiral protrusion should not be excessively segmented, and is generally divided into 3 to 5 segments. If the number of segments is too small, the matching length is not enough; too many sections will have too long a mating length, thereby reducing the overall length (displacement) of the first and second quill axial extension and retraction.
FIG. 20 depicts yet another modified lower housing assembly 40e, including a lower housing 100e, a second casing 300b and a casing seal 400. The lower housing component 40e is connected to the first bushing only in a different manner than the lower housing component 40 d. Briefly, in the lower housing assembly 40d, the lower housing 100 and the first sleeve 200c are separated into two parts, which are injection molded and then joined together. And the lower housing component 40e, in which the lower housing and the first sleeve are integrally connected, is injection molded in one mold to form a single part. Specifically, the lower housing 100e includes a distal housing 47, a lower retaining ring 43 coupled to the distal housing 47 and extending proximally, and a transition housing 45 coupled to the distal housing 47 and extending distally to form the first cannula 200 e. The first cannula 200e includes a first cannula proximal end 210b and a first cannula distal end 230c and a first cannula wall 220b extending therebetween. A plurality of helical lobes 240c of a shape and size matching the helical lobes 340f are included on the inner surface of the first cannula wall at the first cannula distal end 230 c. The first sleeve wall 220b also includes a cylindrical inner tube 250b having a diameter Dt 1. The proximal end of the cylindrical inner tube 250b extends through the first sleeve proximal end 210b and its distal end intersects the helical protrusion 240 c. The spiral protrusion 240c includes a first stage spiral protrusion 241c, a second stage spiral protrusion 242c, and a third stage spiral protrusion 243 c. The first, second and third sections of spiral protrusions are arranged on the inner surface of the wall of the first sleeve at the position of the far end 230c of the first sleeve, are sequentially distributed on a virtual spiral line matched with the spiral protrusions 340f at intervals from the far end to the near end, and are not overlapped from the far end to the near end in a projection view angle.
Fig. 21-24 depict yet another modified lower housing assembly 40f, including a lower housing 100, a first bushing 200f, and a second bushing 300 f. The second cannula 300f includes a second cannula proximal end 310f and a second cannula distal end 330f with a second cannula wall 320f extending therebetween. The outer surface of the second cannula wall 320f includes M (M ≧ 1) helical projections 340f, and the helical projections 340f extend from the vicinity of the second cannula proximal end to the vicinity of the second cannula distal end. The first cannula 200f includes a first cannula proximal end 210b and a first cannula distal end 230f with a first cannula wall 220f extending therebetween. On the inner surface of the first cannula wall at the first cannula distal end 230f, there is included a helical groove 240f shaped and dimensioned to mate with the helical protrusion 340 f. The first sleeve wall 220f also includes a cylindrical inner tube 250b having a diameter Dt 1. The proximal end of the cylindrical inner tube 250b extends through the first sleeve proximal end 210b and its distal end intersects the helical groove 240 f. The proximal end 210b of the first sleeve is connected to the lower housing 100 and the second sleeve 300f is mounted inside the first sleeve 200f, wherein the helical protrusion 340f and the helical groove 240f are mated with each other, and the first sleeve and the second sleeve are axially movable by rotating the second sleeve 300f and the first sleeve 200f relative to each other.
With continued reference to fig. 23-24, the lower housing component 40f further includes a sleeve seal 400f mounted at the proximal end of the second sleeve, the sleeve seal 400f including an outer sealing cylindrical surface 420f having a diameter Dt3 defined by a sealing cylinder 410f and an inner sealing cylindrical surface 430f having a diameter Dt 4. In one version, the second cannula proximal end 310f includes a proximal cylindrical tube 350f having a diameter Dt2, the inner cylindrical sealing surface 430f and the proximal cylindrical tube 350f being secured by glue. The outer sealing cylinder 420f is in contact with the inner surface of the cylindrical inner tube 250 b. In one embodiment, Dt3 is greater than Dt1, i.e., the outer cylindrical surface 420f of the sleeve seal 400f is in interference fit with the cylindrical inner tube 250 b. Sufficient extrusion force is formed between the outer sealing cylindrical surface 420F and the proximal cylindrical pipe 350b to form a rotating peak force F1, the rotating outer force F2 applied to the first sleeve and the second sleeve does not generate relative displacement when F2 is less than or equal to F1; when F2 is larger than F1, the first sleeve and the second sleeve generate relative displacement. Reasonable interference is selected through an experimental method, and the material and the hardness of the sleeve sealing element 400 are reasonably selected, so that the rotating peak force F1 is controlled within a comfortable and safe range, wherein in a specific scheme, F1 is more than or equal to 10N and less than or equal to 20N. When F1 is less than 10N, the safety factor for preventing the first sleeve and the second sleeve from generating unexpected relative displacement is not high enough; when F1 > 20N, the operation comfort of the rotation to cause the relative displacement of the first sleeve and the second sleeve is not good enough.
Similarly, when the lower housing assembly 40f is substituted for the lower housing 40 of the cannula assembly 1 to form a new cannula assembly 1f (not shown) for laparoscopic surgery, the surgeon may rotate the first cannula to move the second cannula relative to the first cannula to change the overall length Ltx of the cannula based on the thickness of the patient's abdominal wall, the position and angle of penetration of the cannula assembly, and the personal handling habits. The depth of the cannula assembly into the abdominal wall is adjusted to achieve the desired placement of the cannula assembly outer section (length H1), body wall section (length H2) and body inner section (length H3).
Those skilled in the art will readily appreciate that the cannula assembly also requires a mating needle. The needle penetrating cannula assembly constitutes a trocar assembly which together then penetrates the abdominal wall of the patient through an incision previously provided therein into the body cavity, and the needle is then removed leaving the cannula as a passage for instruments into and out of the body cavity. The introducer needle generally includes a handle portion, a shaft portion and a distal portion. For example, CN201611125444.3 entitled "improved bladeless visual puncture needle" is incorporated herein by reference, which is the puncture needle disclosed in the chinese invention application filed on 12/9/2016. The sleeve component formed by the telescopic lower shell component can be contracted into the shortest length Lt0 at the initial position, and then is matched with the improved knife-free visual puncture needle to form the trocar component for penetrating the abdominal wall, after the puncture needle is taken away, the first sleeve and the second sleeve are relatively rotated, and further the fixed depth of the sleeve component on the abdominal wall is adjusted, so that the external section (length H1), the body wall section (length H2) and the internal section (length H3) of the sleeve component reach the ideal setting. A retractable needle may also be designed to mate with the retractable cannula assembly.
Many different embodiments and examples of the invention have been shown and described. One of ordinary skill in the art can adapt the methods and apparatus described herein by making appropriate modifications without departing from the scope of the invention. Several modifications have been mentioned, and other modifications will occur to those skilled in the art. The scope of the invention should, therefore, be determined with reference to the appended claims, and not be construed as limited to the details of structure, materials, or acts shown and described in the specification and drawings.
Claims (8)
1. A lower housing assembly that is helically retractable for minimally invasive surgery, comprising:
1) comprises a lower shell, a first sleeve and a second sleeve;
2) the lower shell comprises a far-end shell, one end of the transition shell is connected with the far-end shell, and the other end of the transition shell extends and is connected with the first sleeve;
3) the first cannula including a first cannula proximal end and a first cannula distal end and a first cannula wall extending therebetween, the second cannula including a second cannula proximal end and a second cannula distal end and a second cannula wall extending therebetween;
4) the outer surface of the second casing wall comprises external threads, and the external threads start from the adjacent area of the proximal end of the second casing and extend to the adjacent area of the distal end of the second casing; the inner surface of the first sleeve wall comprises an internal thread matched with the external thread;
5) the proximal end of the second sleeve is mounted inside the first sleeve, and the external thread and the internal thread are matched with each other.
2. The lower housing assembly of claim 1, wherein: the internal thread is arranged on the inner surface of the wall of the first sleeve pipe in the adjacent area of the far end of the first sleeve pipe, and the major diameter Dn of the internal thread is larger than the major diameter Dn of the internal thread; the first casing wall further comprises a cylindrical inner pipe with the diameter Dt1, wherein Dt1 is more than or equal to Dn.
3. The lower housing assembly of claim 2, wherein: the cannula assembly further comprises a cannula seal mounted at the proximal end of the second cannula, the cannula seal comprising a cylindrical sealing wall having a diameter Dt2, wherein Dt2 > Dt 1.
4. The lower housing assembly of claim 3, wherein: relative rotation of the first and second sleeves causes the second sleeve to rotate and move within the first sleeve.
5. A cannula assembly comprising the lower housing assembly of any of claims 1-4, further comprising an upper housing, an instrument seal and a zero seal sandwiched between the upper housing and the lower housing and in a compressed state, the upper housing and the lower housing assembly being connected to each other to form an integral seal system.
6. A block of bushings according to claim 5, characterized in that: the total sleeve length Ltx of the sleeve assembly satisfies the following relationship:
Lt0≤Ltx≤(Lt0+L1-N*P-L3)
l1 — length of first sleeve,
n is the number of turns of the internal thread,
l3 — shortest distance of external thread from proximal end of second sleeve,
lt 0-initial position shortest length of total cannula length of cannula assembly,
p-the pitch of the thread.
7. A block of bushings according to claim 6, characterized in that: the number of turns of the internal thread is N, wherein N is more than or equal to 3 and less than or equal to 5.
8. A cannula assembly as set forth in claim 6, wherein the length L1 of the first cannula and the initial position minimum length Lt0 of the total length of the cannula assembly satisfy the relationship: 3/Lt 0/8 is not less than L1 is not less than Lt 0/3.
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| CN202010784981.9A CN111920489B (en) | 2020-08-06 | 2020-08-06 | Spirally-telescopic lower shell assembly for minimally invasive surgery |
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| CN202010784981.9A CN111920489B (en) | 2020-08-06 | 2020-08-06 | Spirally-telescopic lower shell assembly for minimally invasive surgery |
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| CN113633385A (en) * | 2021-08-03 | 2021-11-12 | 赵宇 | Terminal device of minimally invasive surgery robot |
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